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Charging more for primary health care 'penny wise, pound foolish' -

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TONY EASTLEY: As we've just heard, the election stoush over healthcare was a hot topic today.

At the heart of the debate is whether Australians can continue to expect the same quality of healthcare at the same price.

Lexi Metherell reports.

LEXI METHERELL: Last year, the Federal Treasury calculated annual health spending per person of about $2,800.

It found that if the same policies were kept, that would rise to $6,600 by the middle of the century.

The health program director at the Grattan Institute, Stephen Duckett, says there are costs to be cut in health spending, but it's also important to remember that that spending is an investment in people's wellbeing.

STEPHEN DUCKETT: It's not the right lens to say look this is entirely a cost, because we are getting something for the money we spend.

LEXI METHERELL: The Prime Minister Malcolm Turnbull says Australia must live within its means when it comes to health expenditure.

He says Labor's plan to remove the freeze on the Medicare rebate would be a big cost to the budget, but would only add 60 cents to each GP consultation.

A senior research analyst at the Family Medicine Research Centre at University of Sydney, Christopher Harrison, says that calculation depends on some assumptions.

CHRISTOPHER HARRISON: It's assuming that the indexation will be 1.65 per cent, which is far below the CPI that's projected in the budget.

LEXI METHERELL: The Prime Minister has rubbished the Opposition leader’s claim that doctors will begin charging patients $20 more per consultation because of the freeze.

That figure comes from the lobby group for GPs, the Australian Medical Association.

But Christopher Harrison says it's probably reasonable.

CHRISTOPHER HARRISON: GPs have had increases below, well below CPI for quite some time, and if GPs are to make the change to private billing, to charging patients money for the services instead of just relying on bulk billing, it's reasonable that GPs would charge more to make up for the other losses.

STEPHEN DUCKETT: I think a co-payment is what they say; penny wise and pound foolish.

LEXI METHERELL: The Grattan Institute's Stephen Duckett says continuing to freeze Medicare rebates is unwise.

STEPHEN DUCKETT: It only needs a small number of GP visits not to be made and then lead on to hospitalisation, that you've wiped out all your savings, because the point of general practice is this is where problems are sorted, this is where problems can be identified, this is where problems can be nipped in the bud.

And if a person's health issues continue without going to see a doctor, they may end up going to an emergency department, which is way more expensive than a general practice, and may end up having to be admitted into hospital which is even orders of magnitude more expensive than general practice.

LEXI METHERELL: What is the evidence that people already don't go to see the doctor or don't pay for their prescriptions because of the cost?

STEPHEN DUCKETT: The Australian Bureau of Statistics conducts a regular survey. The most recent one I think was last year, called the patient experience survey, which found that one in 20 Australian's didn't go to see a doctor and I think for prescriptions but it's roughly similar.

LEXI METHERELL: There's also a new election fight over the cost of medicines. The Coalition has budgeted for a $5 charge on prescriptions for regular patients and a charge of 80 cents for pensioners and children.

Labor says it wouldn’t introduce the payments. That would cost the budget $971 million over the next four years.

But Stephen Duckett says Australian out of pocket payments on health are already high in global terms.

STEPHEN DUCKETT: I think the increase co-payments is a short sighted move because it means that necessary drugs aren't going to be used, which means people might end up sicker and end up in hospital rather than being able to be kept out of hospital with prescription medication.

LEXI METHERELL: Do we need to make savings though in parts of the system?

STEPHEN DUCKETT: Look, I think there are plenty of savings to be made in the health system, even in pharmaceuticals, for example.

Our prices practices for the pharmaceutical benefits scheme leave a lot to be desired, so I don't want go on record as saying that there isn't money to be saved in the health system, but you've got to save the money wisely.

TONY EASTLEY: Health program director at the Grattan Institute, Stephen Duckett. Our reporter there Lexi Metherell.